Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium.
Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium.
J Stomatol Oral Maxillofac Surg. 2024 Jun;125(3S):101857. doi: 10.1016/j.jormas.2024.101857. Epub 2024 Mar 29.
This study aims to quantify the facial symmetry of surgically treated zygomaticomaxillary complex (ZMC) fractures through a new reliable three-dimensional evaluation method, which is crucial for improving post-operative aesthetic and functional outcomes.
Healthy patients and patients with surgically treated ZMC fractures were retrospectively reviewed. Using Brainlab Elements® the zygomatic bone and the orbit of each patient was segmented and mirrored. Subsequently, the mirrored side was matched with the other side via volume-based registration, using the segmented orbit as reference. Volumetric asymmetry was measured using 3-matic software, and a surface-based matching technique was used to calculate the mean absolute differences (MAD) between the surfaces of the two sides of the ZMC. The reliability of this novel method using volume-based registration was tested, and the intra-class correlation coefficient was assessed.
The MAD between the surfaces of the left and right sides in the control group was 0.51 mm (±0.09). As for the ZMC fracture group, MAD was 0.78 mm (±0.20) and 0.72 mm (±0.15) pre- and post-operatively, respectively. The MAD showed statistically significant differences between pre- and post-operative groups (p = 0.005) and between control and post-operative groups (p < 0.001). The intra-class correlation coefficient was high (≥0.99).
This evaluation method using mirroring and volume-based registration to determine the symmetrical position of the ZMC is reliable. The surface-based measurements revealed an improved symmetry after surgery. However, the symmetry of the treated patients remained lower than the control group.
本研究旨在通过一种新的可靠的三维评估方法来量化手术治疗的颧骨复合体（ZMC）骨折的面部对称性，这对于改善术后美学和功能结果至关重要。
回顾性分析健康患者和手术治疗的 ZMC 骨折患者。使用 Brainlab Elements®对每位患者的颧骨和眼眶进行分割和镜像。随后，通过基于体积的配准将镜像侧与另一侧匹配，以分割的眼眶作为参考。使用 3-matic 软件测量体积不对称性，并使用基于表面的匹配技术计算 ZMC 两侧表面之间的平均绝对差异（MAD）。测试了基于体积配准的这种新方法的可靠性，并评估了组内相关系数。
对照组左侧和右侧表面之间的 MAD 为 0.51 毫米（±0.09）。对于 ZMC 骨折组，术前和术后的 MAD 分别为 0.78 毫米（±0.20）和 0.72 毫米（±0.15）。术前和术后组之间的 MAD 差异具有统计学意义（p = 0.005），且与对照组和术后组之间的 MAD 差异也具有统计学意义（p < 0.001）。组内相关系数较高（≥0.99）。
使用镜像和基于体积的配准来确定 ZMC 对称位置的这种评估方法是可靠的。基于表面的测量显示手术后对称性得到改善。然而，治疗患者的对称性仍低于对照组。
